目的 系統(tǒng)評(píng)價(jià)阿托伐他汀對(duì)比瑞舒伐他汀對(duì)經(jīng)皮冠狀動(dòng)脈介入（PCI）術(shù)后遠(yuǎn)期心功能及不良心血管事件（MACE）的影響。方法 計(jì)算機(jī)檢索中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、維普中文期刊全文數(shù)據(jù)庫(kù)（VIP）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM）、萬方數(shù)據(jù)庫(kù)、PubMed、Cochrane Library和Web of Science，搜集阿托伐他汀對(duì)比瑞舒伐他汀治療心臟病患者PCI術(shù)后的臨床隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)限從建庫(kù)至2020年10月30日，采用RevMan 5.3軟件進(jìn)行Meta分析。結(jié)果 共納入14項(xiàng)RCTs，2 693例患者。Meta分析結(jié)果顯示：阿托伐他汀組左心室射血分?jǐn)?shù)（LVEF）小于瑞舒伐他汀組[MD=-5.56，95% CI=（-7.56，-3.56），P<0.01]，MACE高于瑞舒伐他汀組[RR=1.51，95% CI=（1.23，1.85），P<0.01]，超敏C-反應(yīng)蛋白（hs-CRP）高于瑞舒伐他汀組[RR=0.79，95% CI=（0.40，1.18），P<0.01]，總膽固醇（TC）高于瑞舒伐他汀組[RR=0.45，95% CI=（0.35，0.54），P<0.01]，而支架內(nèi)再狹窄[RR=1.17，95% CI=（0.84，1.63），P=0.36]和不良反應(yīng)[RR=1.12，95% CI=（0.89，1.41），P=0.33]與瑞舒伐他汀組比較無顯著差異。結(jié)論 瑞舒伐他汀對(duì)心臟疾病患者PCI術(shù)后遠(yuǎn)期心功能改善程度、降低hs-CRP和TC水平，減少M(fèi)ACE的發(fā)生均優(yōu)于阿托伐他汀，但該結(jié)果仍需大樣本、高質(zhì)量的RCT驗(yàn)證。

Objective To systematically evaluate the effects of atorvastatin vs rosuvastatin on long-term cardiac function and major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). Methods Chinese and English databases including CNKI, VIP, CBM, WanFang, PubMed, Cochrane Library and Web of Science were searched by computer to collect the randomized controlled trials (RCTs) on atorvastatin vs rosuvastatin treatment of patients with heart disease after PCI from the database establishment to October 30, 2020. The Meta-analysis was performed by using RevMan 5.3 software. Results A total of 14 RCTs were included, involving 2 639 patients. The results of Meta analysis showed that LVEF% in atorvastatin group was lower than that in rosuvastatin group[MD=-5.56, 95%CI=(-7.56, -3.56), P<0.01], MACE was higher than rosuvastatin group[RR=1.51, 95%CI=(1.23, 1.85), P<0.01], high sensitive c-reactive protein (hs-CRP) levels was higher than that in rosuvastatin group[RR=0.79, 95%CI=(0.40, 1.18), P<0.01], total cholesterol (TC) levels was higher than rosuvastatin[RR=0.45, 95%CI=(0.35, 0.54), P<0.01], and In-stent restenosis[RR=1.17, 95%CI=(0.84, 1.63), P=0.36] and adverse reactions[RR=1.12, 95%CI=(0.89, 1.41), P=0.33] were not significantly different from those in the rosuvastatin group. Conclusion Rosuvastatin is superior to atorvastatin in terms of long-term improvement of cardiac function, reduction of hs-CRP and TC levels, and reduction of MACE after PCI in patients with heart disease, but the results of this study need to be validated by a large, high quality RCT.

R972

湖北省自然科學(xué)基金項(xiàng)目（2015CFC823）